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Med Surg 1 > Integumentary > Flashcards

Integumentary Flashcards

1
Q

Plaque vs bulla

A

Plaque: solid raised lesion, > 1cm
Bulla: fluid filled blister

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2
Q

Macule

A

Flat, nonpalpable (similar to freckle)

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3
Q

Papule

A

Palpable solid raised lesion (ex: mole)

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4
Q

Vesicle

A

Small raised area (< 1cm diameter) (ex: chickenpox, shingles)

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5
Q

Med term for hair loss

A

Alopecia

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6
Q

What does spoon-shaped nails usually indicate?

A

Anemia

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7
Q

What does thick yellow nails usually indicate?

A

Fungal infection

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8
Q

If doing skin testing for diagnostic tests, what should you always have in the room and why?

A

Always have a crash cart in the room b/c the things that the pt is getting are probably the ones that they are allergic to

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9
Q

What should the dressing be when applied on skin?

A

Open wet dressings, can be sterile or clean

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10
Q

What does open wet dressing help with?

A

Decrease inflammation, cleanse and dry wounds, promote drainage of infected area

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11
Q

How often should you use the open wet dressings?

A

Dressing should be on the patient for 15-30 mintues, reapply after 3-4 hours as ordered

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12
Q

What is balneotherapy?

A

Hot baths, remember to always apply lubrication after

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13
Q

What does Burow’s solution do got wet dressings?

A

Relieve rashes, help stop the growth of bacteria and fungus

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14
Q

If patient gets chill after 20 minutes of wet dressing, what should you do?

A

Remove the dressing and cover patient up with a warm blanket. Next time should cover non-dressed area with warm blanket.

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15
Q

Pressure injuries patho

A

Pressure against skin (pressure, friction, shear), tissue anoxia (loss of O2)

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16
Q

What does Braden Scale’s scores mean?

A

Lower score = higher risk of skin breakdown

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17
Q

Physician ordered to debride a pressure ulcer in 1 hour, what is the nurse’s first action?
1. Ask physician to order antibiotics for treating pressure ulcer
2. Hand hygiene
3. Premedicate the pt 45 min prior to procedure
4. Gather supplies

A

3! Premedicate

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18
Q

Can you use an autolytic debridement on an infected wound?

A

No, b/c it’s for pressure ulcers not for wounds, and it means 自溶性的

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19
Q

Types of dermatitis - contact

A

Acute or chronic.
Caused by contact with irritation or allergen.
Ex: poison ivy, perfume, medication

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20
Q

Types of dermatitis - atopic（特应性）

A

Chronic.
Inherited, may be associated with resp allergies or asthma.
Bright red macules, papules, hyperpigmented areas

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21
Q

Types of dermatitis - seborrheic（脂溢性）

A

Chronic.
Inflammatory, too much production of sebaceous secretions.
Can appear as dry, moist, or greasy scales, yellow or pink-yellow crusts, redness, and dry flakiness

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22
Q

Is it easier or harder to get dermatitis the second time?

A

Easier

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23
Q

What can you use to treat dermatits?

A

Antihistamine
Analgesics
Steroids
Wet dressings
Colloidal oatmeal baths
Antipruritics（止痒药）

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24
Q

Psoriasis patho

A

Inflammatory disorder, caused by overproduction of epidermal cells, cause silvery scales

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25
What types of medication can aggravate psoriasis?
Beta-blockers, lithium, antimalarial agents
26
What can aggravate psoriasis other than meds?
Stress, alcohol and smoking, cold weather, skin trauma
27
Normal vs psoriasis skin cell divide times
Normal: every 27 days Psoriasis: every 4-5 days
28
S/s of psoriasis
Red papules, silvery scales, itching
29
Where does psoriasis usually occur?
Elbows, knees, scalp, torso, genitals
30
How do clothes affect psoriasis patients?
Clothes can rub on their skin and can be very uncomfortable
31
What can psoriasis lead to?
Infection, psoriasis arthritis, nail changes, lymphadenopathy（淋巴结肿大）
32
Interventions for psoriasis
Corticosteroids, keratolytics (topical salicylate acid), vit D creams, UV light, tub baths, Tar Preparations (anti myotic: slows down cell division)
33
Why does psoriasis patients need to drink a lot of water?
To keep skin hydrated
34
Herpes Simplex Virus (HSV) patho
Viral/primary infection, ex: direct contact/sex, resp droplet, fluid exposure...
35
HSV1 vs HSV2
HSV1: above waist, no cure (b/c more easier to retrigger) HSV2: below waist, has a cure (ex: genital herpes)
36
HSVs have no s/s when first occurred b/c?
It usually lies dormant（处于休眠状态）
37
What can trigger herpes?
Stress
38
Prodromal phase of HSV
S/s first appearing before getting severe, can be contagious for 2-4 days before crust form
39
If no tx, how long does HSV lesions heal?
1-4 weeks
40
HSV s/s
Burning, tingling, pustules burning itching pain, contagious until crusts form
41
Interventions for HSV
No complete cure, antiviral, avoid triggers for reoccurrence. Antibiotics can treat secondary infection
42
Herpes Zoster (Shingles) patho
Acute inflammation/infection occurs after chickenpox. Reduced immune function: elderly, AIDs, immunosuppressed Painful vesicles, follows nerve distribution, usually one-sided
43
Herpes Zoster (Shingles) most common area
Start from the lower back, comes around the front following the nerve
44
What can Herpes Zonster lead to?
Sepsis Hyperesthesia (increased sensitivity to the skin) Ophthalmic herpes zoster Postherpetic neuralgia Persistent dermatomal pain (painful blisters and rashes along the line of distribution)
45
Interventions for herpes zoster
1. Acyclovir (Zovirax) (IV, oral, topical) (has to start within 72 hours of onset of symptoms) 2. Analgesics 3. Anticonvulsants/antidepressants (for neuropathic pain) 4. Antihistamines 5. Corticosteroids (used in combination of antivirals, not by itself) 6. Antibiotics (secondary infection) 7. Can use cold compresses or take cool baths to calm the nerves (not pregnant women b/c body is more sensitive)
46
fungal infections patho
Direct contact with fungus, overgrowth with antibiotic therapy, grows in warm moist environment
47
What is tinea?
癣, skin/fungal infections
48
Interventions for fungal infections
Keep skin clean and dry Topical antifungals Oral antifungals (fluconazole (most common)) Corticosteroids Teach to avoid spread
49
Cellulitis patho
Inflammation of skin and connective tissue. Infection (ex: MRSA, streptococcus) Open wound/trauma Or the cause can be unknown
50
Cellulitis s/s
Warm, red, edema, pain, tender, fever, lymphadenopathy
51
What to do when you have a cellulitis pt come in?
Outline where cellulitis started, have a baseline Measure at least daily so you can tell if meds are working Can apply warm compress to increase circulation
52
Interventions for cellulitis
Antibiotics (topical, systemic) Debridement Elevate area to reduce swelling
53
Why can't a cellulitis patient get a CT scan with contrast?
b/c they already have fluids
54
What should you monitor for cellulitis patient?
Monitor for sepsis and monitor the area for progress
55
Acne Vulgaris patho
Increased sebum production, overload and clog pilosebaceous ducts cause comedones (open: blackheads; closed: whiteheads), hormone changes
56
Where do blackheads come from?
Lipid and malignant pigment. Popping can cause scarring
57
Interventions for acne vulgaris
Vitamin A acid (a type of retinoid) Antibiotics (very severe cases) Isotretinoin (less severe) Estrogen therapy (hormone) Benzoyl peroxide They usually take 3-6 weeks before seeing improvement
58
Pediculosis patho
Infestation by lice, transmitted by direct contact
59
3 types of pediculosis
Capitis: head lice Corporis: body lice Pubis: pubic lice
60
Pediculosis s/s
Itching, rash, presence of lice, nits (eggs), and excreta (feces)
61
Pt education on pediculosis
Self-medication: pyrethrin (Rid) Removal of nits: that very think metal comb Clean clothes and objects Inspect family and friends: b/c it's contagious
62
how should patient wash clothes if they have pediculosis (lice)?
Wash clothes separately from other people and use extremely hot water. Unwashable (hats...) needs to be sealed in a bag and put in garage for 10 days
63
How long does it take dice to die without human contact?
1-3 days
64
Does shampoo and lotion get rid of nits?
They kill nits but don't remove them, so need the special thin metal comb to remove nits
65
Scabies patho
Sarcoptes scabiei mites burrow into skin. Caused by contact with infected clothing or animals
66
Difference between pediculosis and scabies
Pediculosis doesn't affect animals, but scabies do
67
When does symptom start after contact for scabies?
4 weeks after contact
68
Scabies s/s
Itching, rash (small, scattered, papules), burrows, short brown wavy lines on skin
69
Interventions for scabies
Topical scabicides (permethrin, crotamiton) Antipruritics（止痒药）
70
How long without human contact will scabies die?
< 24 hours
71
Patient education for scabies
Self-medication Warm, soapy baths Treat family members and animals Wash clothes and linens separately Itching may continue 2 weeks after tx
72
Basal cell carcinoma
Most common type of skin cancer
73
Squamous cell carcinoma
Lower lip, neck, tongue, head, posterior surfaces of hands
74
Malignant melanoma
Usually developed from a mole, higher mortality rate
75
What is something you can educate the patient on if they have malignant skin lesions?
Do yearly head to toe checks and make sure there are no changes to the moles
76
What to educate patients on prevention of malignant skin lesions?
1. Limit exposure to UV light 2. Sunscreen, long sleeves 3. Report any changes in moles (size, borders, colors)
77
Why is fluid important for burns?
b/c the first 48h after burns: fluid shifts, leads to hypovolemia, which can lead to shock
78
Rule of nines for adults
Face head neck: 9% Back: 18 Front: 18 L and R arm: 9 + 9 Genital: 1 L and R leg: 18 + 18
79
Rule of nines for children
Face head neck: 18% Back: 18 Front: 18 L and R arms: 9 + 9 Genital: 1 L and R leg: 13.5 + 13.5
80
1st~2nd degree burn
Epidermis. Bright red to pink, should blanch, has serum built blister Sensitive to air and touch Takes 7-10 days to heal
81
2nd~3rd degree burn
1/2~7/8 of dermis. Pink to light red or white color, blancheable, soft Sensitive, but includes pain to pressure b/c exposed nerve ending
82
How long does it take skin grafting to heal?
14-21 days
83
3rd~4th degree burns
All skin layers are through and go to bone and muscle. Skin firm and leathery, no pain b/c all nerve endings are destroyed This will need skin grafting
84
Contact burns ex
Hot metal, hot grease, hot E cigarettes
85
Scalding burn
Hot liquid, < 5/>65/clumpy
86
Electrical burns
Most serious burns b/c bones have resistance to alzheimer's so cause more damage
87
Interventions for major burns (emergent stage)
This is when pt first come in and was burnt. 1. ABCs (make sure this is stable) 2. Stop the burning process 3. Stabilize related injuries 4. IV fluids 5. Pain control
88
Split-thickness skin graft (STSG)
Epidermis and partial of dermis prone to chronic break down of continuous...?
89
Full thickness skin graft (FTSG)
Color match, more likely to grow hair, but take longer to heal at the donor site.
90
What is escharotomy
Skin too hypertrophy and thick, make relief cuts, increase circulation
91
What position does burnt patient like to be in?
They like when their extremities are in a contractured position.

Med Surg 1 (3 decks)

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